Substantial improvement with (strange) dietary adjustments

[Wonkmonk]

Keep in mind that high uric acid (Gout)...some people have the ability to produce uric acid crystals from Niacin...

Thank you, I was vaguely aware of that risk, but don't think it's a problem for me since I do not consume a high protein diet and especially, as a vegan, almost no aminal protein (only very low amounts very rarely when we have guests). I'm also currently eating two pounds of fruit each morning and lots of vegetables which should lower urine PH and therefore prevent any kidney stone formation. I also do not take high-dose niacin supplements. So all in all, I don't think that's a concern for me, at least not currently.

But very useful to spell this out. Thanks for that!

 

[Wonkmonk]

I think the problem with greens isn't Omega 3. It's probably something else, because other foods that contain Omega 3s in similar amounts do not cause the same symptoms. (Omega 3s appear to be problematic from whatever source in high doses, but greens do not contain very high doses).

I think it's something else in the greens, I'm suspecting carotinoids. That could also explain why raw tomatos are less problematic than fresh tomatos. The red pigment (lycopine) is a carotinoid, but it is much more concentrated and bioavailable in tomato paste than in fresh tomatos.

I will reduce my consumption of greens, tomatos and also carotinoid containing fruit like mangos. Most colors in fruit are anthocyanines and not carotinoids. Anthocyanines do not appear to cause problems.

 

[cheeseater]

Wonkmonk the uric acid crystals that I am talking about causing the gout from highish Niacin intake can happen in some people that have never had gout before, If you do have gout already, I would be especially careful of using much of any Niacin (not niacinamide, which does not do it). If a health professonal suggests Niacin for some reason, they should warn you of the possibility of severe joint pain that can develop in some people. It has nothing to do with your diet, unless you already have gout.

 

[Wonkmonk]

Hi, cheeseater,

I don't take high doses of niacin. I'm on a largely vegan diet (had to abandon 100% vegan lately) and niacin is usually abundant in plant foods. But that's definitely an important concern.

 

[Wonkmonk]

I am currently exploring the hypothesis that the combination of oxalates and calcium in meals or on the same day makes me particularly sick, possibly exacerbated by certain types of fat, fructose, carotinoids, acids or some fibers.

Perhaps the worst food of all is spinach lasagna, which has lots of oxalates and carotinoids in the spinach and whole grains, lots of fat of all sorts, fiber in the whole grains and even some fructose in the onions/garlic.

When I eat plain lentils, that's usually ok up to a certain point. But when I add higher quantities of kale (high in calcium), it appears to become a problem.

I do not really think it's the oxalate per se, because calcium should BLOCK oxalate absorption. Especially the high load of calcium in the copious amounts of cheese used in the spinach lasagna.

I think it's a bacterial fermentation product made from oxalates.

Whatever it is, I seem to be tolerating white pasta much better than whole grain, so I switched to that. And I probably won't combine kale with legumes anymore, which have higher amounts of oxalates.

That all being said, I am not entirely sure this is about oxalates. Could be some fiber, phytate, tannin, saponin or other compound present in whole grains and legumes. I think it's oxalates because spinach makes everything so much worse.

Apart from that, it has been confirmed again that plant-based Omega-3s must be avoided (tried a vegan margarine with 3% omega 3 from walnut oil...not good).

On the brighter side, it looks like some restrictions regarding oils and fats can be relaxed if the meals do not contain high oxalate or high fiber foods, i.e., white bread with low-oxalate nut butters (e.g., hazelnut) could be introduced occasionally.

 

[Wonkmonk]

@Aidan Have you ever noticed that the combination of oxalates and calcium makes you worse more than calcium alone? I am seeing more and more evidence for that in my case.

 

[cheeseater]

Wonkmonk you are describing textbook gout symptoms.

From google search "spinach causes joint pain"

""If you are suffering from joint issues: Along with oxalic acid, spinach is also rich in purine, a type of compound. These two compounds together may trigger gout, a type of arthritis. For those who are already suffering from joint pain, swelling, and inflammation, excess spinach intake may worsen the symptoms.""

 

[Wonkmonk]

Hello Cheeseater, thank you so much for the suggestion. It's very important to keep an open mind and not fall victim to ones own confirmation biases. I will definitely look into this in more detail.

My first thought was that it can't be gout because from what I have read so far, gout tends to be largely limited to joint pain, swelling and inflammation.

I have not seen reports that gout causes massive fatigue, head aches, heart palpitation, nose bleeding, chest pains, brain fog, inability to concentrate, stress intolerance, sleep disturbances and sore muscles all over the body.

Because that's what happens when I eat spinach lasagna or larger amounts of lentils and kale. I would agree that there is a gout-like element to it, but this is probably something else. It does not appear to be this simple.

 

[Wonkmonk]

Have to add: The purine suggestion is an interesting one.

I found this list as the first hit on Google. I hope it's accurate.

https://elevatehealthaz.com/wp-content/Purine Table.pdf

Many of the high-purine foods are indeed causing symptoms. But then again other like brewer's yeast (nutritional yeast) don't appear to be problematic.

It would also be strange if I had gout and this would somehow explain all of this. I've been on a vegan diet for about 2 years and only recently (grudgingly) reintroduced some cheese and milk because I could not find enough foods I can tolerate. My overall purine intake should be rather low.

But maybe foods that are associated with gout also worsen my symptoms (whatever the cause is).

 

[Wonkmonk]

One more thing about fiber. I don't think fiber per se is the problem or at least not all types of fiber. To check this I ate as much low-oxalate fruit as I could in a fasting state after breakfast. I could do almost 5 pounds, so that's probably maxing out my stomach capacity. That should be over 60 grams of fiber. It did not cause a major worsening of symptoms.

 

[Wonkmonk]

Oh, and gout also wouldn't explain my massive overall deterioration just days after starting levothyroxine replacement therapy. I basically went from almost fully socially functioning to debilitated and unable to work within a few weeks.

I haven't seen any reports that this happens with gout when levothyroxine replacement is started.

Gout-causing foods may be part of the puzzle, but I would be very surprised if all I have is attributable to just gout.

 

[cheeseater]

If you have gout, you have gout. Certain foods make gout symptoms worse. Fairly simple test at a clinic to determine. Quite treatable with medication. If you do not treat gout in a timely manner it will cause more and more damage to your body.

 

[Aidan]

@Aidan Have you ever noticed that the combination of oxalates and calcium makes you worse more than calcium alone? I am seeing more and more evidence for that in my case.

I think so but I'm not entirely sure. I know that there are definitely additional factors that affect how well I tolerate a given amount of calcium. I ate tahini a few times and was very sensitive to getting negative symptoms from that and it is high in oxalates and calcium. The same is true of almonds, just a small handful before bed and I was waking up throughout the night extremely dehydrated. Also found the same with amaranth, which again is high in both calcium and oxalates. Interestingly, I seem to have over time become more sensitive to kale and chickpeas. I used to eat a significant amount of them without issue but over the last few months I've had to entirely ditch both. Strange since neither are high in oxalates. But yes, overall I think I experience the same thing although I haven't checked it rigorously. The safest food for me to get calcium seems to be via brown bread

 

[Wonkmonk]

I ate tahini a few times and was very sensitive to getting negative symptoms from that and it is high in oxalates and calcium. The same is true of almonds

Same here...tahini, hummus, almond milk. I had to largely eleminate them all from my diet.

I will pursue the calcium-oxalate avenue more rigorously in the next few weeks, and basically try to separate them as much as possible. One has to look out for hidden sources of calcium, e.g., tap water for cooking. I found ours is very high in calcium, so I bought some low calcium non-sparkling mineral water and will try to cook higher oxalate foods with that.

There is also oxalate in foods that weren't on my list, e.g., lentils. When I have 300g of lentils (1 meal = 1000 calories) with kale and tap water for cooking, that's hundreds of mg of both oxalates and calcium.

I think the combination of both seems to hurt me the most, either in isolation maybe not so much or not at all. But I have to find all hidden sources so I can really separate them. Meal mixing might also play a role, so there has to be a certain time interval between oxalate- and calcium-containing meals.

What makes it very complicated is that symptoms after a mixed calcium-oxalate meal usually persist for about 3 days and occasionally flare up and disappear again. That's very distracting because it makes it hard to pinpoint which meal exactly caused the symptoms.

What also makes it difficult is the high variety in oxalate and calcium contents in different sources. For potatos, I found calcium contents ranging from 6 mg to 57 mg per 100g. For carrots, I found anything from 50mg per 100g to 500 mg per cup.

I will definitely explore this in more detail in weeks ahead.

 

[Wonkmonk]

If you have gout, you have gout. Certain foods make gout symptoms worse. Fairly simple test at a clinic to determine.

Thanks so much for the suggestion. It's so important to always look left and right. I think uric acid was tested once, and it was low, but I read it's not a completely reliable indicator. I might have to do further tests.

 

[Wonkmonk]

Update on the impact of the dietary approach:

I have improved to a point where I can accompany my mother to grocery shopping on the weekends. The trip usually lasts for several hours, and I can do it with relative ease. I think if I absolutely had to, I could do it alone. Still far away from being able to have my own household or to work.

 

[Wonkmonk]

I think what's happening is when I find something out (like the oxalate thing or the Omega 3s), I improve very quickly to some extent, but then hit a new permanently high plateau. Sadly, I haven't been able to find a diet on which I am just slowly and continuously improving more and more (just as I deteriorated more and more before I changed the diet), which at least in theory could lead to remission or even healing.

I think this is because
a) I haven't found a diet I can settle on so far. I have to try new things because it's hard to follow (few foods available) and to some degree nutrient deficient (for which I take supplements)
b) There may be nutrients/antinutrients left in my diet, or perhaps in any diet, of which I don't know and they are causing the worsening. As such there may be no diet that eliminates them all.
c) Diet may be only one factor and even if the perfect diet were found, there might still be an underlying disease that would prevent me from going into full remission or being cured. My theory so far has been that dietary factor activate a dormant/intrcellular virus or help it with replication. If the perfect diet were found, the virus might still be there and the body unable to clear it, leading to persistence of at least some symptoms.

That all being said, my feeling is that I can make some more substantial improvements with some more tinkering and adjustments to the diet. If I can improve some more, the point where I could get something resembling a normal life back (own apartment, part-time job etc.) isn't all too far away. I don't know if it's achievable, but at this point I no longer think it's impossible.

 

[Wonkmonk]

I have to make a few more checks, but I think white rice makes me worse. It's low in oxalates so that doesn't fit into the oxalate theory, but it might be the high arsenic content.

I also tried bananas and it wasn't good either. Not really sure why. I suspect it's because bananas naturally ferment during ripening. That's why overripe bananas sometimes have a slightly pungent taste. It's from alcohol produced by the bacteria.

 

[Aidan]

I have to make a few more checks, but I think white rice makes me worse. It's low in oxalates so that doesn't fit into the oxalate theory, but it might be the high arsenic content.

I also tried bananas and it wasn't good either. Not really sure why. I suspect it's because bananas naturally ferment during ripening. That's why overripe bananas sometimes have a slightly pungent taste. It's from alcohol produced by the bacteria.

I have problems with rice too. If I eat it for a few meals I start getting really exhausted and sleepy the following day to the point that I have to take a nap soon after breakfast. I usually don't nap very often. It's something particular to rice that goes beyond it's nutrient composition because Im fine with bread and other grains

 

[xploit316]

@Wonkmonk Do you drink Coke or Pepsi? My digestion and mood seem to get better substantially even with a 100ml serving taken once in the morning with breakfast and lasts the entire day. Only issue is that if I exceed this amount than falling asleep early at night can be an issue.

On white rice, do you strain your rice properly with water to remove excess starch before cooking it? Also after cooking make sure to strain the rice to remove the starchy water.